Better memory, greater motivation and concentration lead to greater productivity, efficiency and performance, all of which are features that are highly valued in a modern society focused on productivity. In the effort for better cognitive abilities, otherwise healthy individuals use cognitive enhancers, medicines for the treatment of cognitive deficits of patients with various disorders and health problems, such as Alzheimer’s disease, schizophrenia, stroke, Attention Deficit Hyperactivity Disorder or ageing. The use of these is more common in professions with emphasised cognitive (...) abilities, or in occupations that require more attention, focus and alertness. Their use is also associated with the general working population, in that they are supposed to use them to alleviate the effects of sleep deprivation and to cope with increasing workloads. In the paper, we are addressing the ethical issue and the dilemmas of the use of pharmaceutical enhancements by healthy people who have no medical reason for taking such substances, in the context of improving their cognitive functions. (shrink)

Hydrogen is a very important industrial gas in chemical processes. It is very volatile; therefore, it can escape from the process units and its mass balance is not always correct. In many industrial processes where hydrogen is reacted, kinetics are often related to hydrogen pressure. The right thermodynamic properties of hydrogen can be found for a process simulation and optimization; they can be estimated by the Grayson-Streed model. In the case studied, a methanol plant with a capacity of 150,000 tons/year, (...) the flow rate of hydrogen (H2) can be optimized using nonlinear programming, but good estimates of thermodynamic properties of hydrogen had to be found. In the case study, the model is in relatively good agreement with experimental measurements in the existing methanol production plant. An additional flow rate of hydrogen can increase the methanol production by 1.2%. Total potential profit increase of the additional methanol production was estimated to be 30 kEUR/a (or 103 euros/year). (shrink)

Markomanske vojne so bile največji in najobsežnejši oboroženi spo­pad rimske vojske in barbarskih plemen ob osrednjem Podonavju – Markomanov, Kvadov in Sarmatov skupaj s še drugimi plemeni. Vojne z germanskimi plemeni so svoje prve kali kazale že v obdobju Antonina Pija, miroljubnega predhodnika Marka Avrelija, ki je težnje uzurpatorjev skrbno umirjal s konsistentnim pacifizmom. V Panonijo so prihajala poslanstva germanskih kraljevin izza Donave, ki so vznemirjala z vestmi o premikih barbarskih ljudstev s severa. Trgovanje barbarskih ljudstev z rimskimi državljani na (...) mejah rimske države in migracije v germanskem bazenu plemen so v pasu ob limesu predstavljali težnje le-teh po dodatnem habitatu znotraj imperija. Apijan piše, da so poslanstva teh plemen prišla celo v Rim k cesarju Antoninu Piju in ga prosila za sprejem v imperij. Kontinuirani pritiski so eskalirali najverjetneje v l. 166, ko je bil velik del rimske garnizije stacioniran na vzhodni meji v boju s Parti. Limes je bil v tem obdobju slabo zavarovan, saj so bile čete legij, stacioniranih od Rena do Donave, poslane na fronto s Parti. Kljub prizadevanju cesarskih namestnikov v obeh Panonijah, da bi preprečili izbruh vojne na utrjeni državni meji z Donavo, je barbarom uspel preboj čez limes in posledično prodor vse do Akvileje in Opitergija. Boleča zavest o ranljivosti Italije, ki jo je avgustejski mir (Pax Romana) uspaval za več rodov, je prinesla nagel zasuk v obrambi. Pričujoče besedilo pretresa dva glavna vira za dogodke med germansko-sarmatsko vojno in postavlja vprašanja o odsotnosti omemb pomembnega obrambnega sistema, t.i. »Pre­tenture Italije in Alp«. (shrink)

Mediteran je prostor susreta. Susretanje s jedne strane znači komunikaciju, aktivnost, otvorenost, prožimanje, dok s druge strane znači i sukob, često i rat, uništenje, istrebljenje. Susretanje je, dakle, istodobno opasnost i šansa, prijetnja i prigoda, mogućnost iščeznuća i predložak za novi kvalitet, što se na Mediteranu jasno ogleda. Neprestani napon, odnosi harmonije i suprotnosti, sličnosti i različitosti, pokazuju Mediteran u bitnom upravo kao prostor posredovanja, a posredovanje kao uvjet mogućnosti nečeg takovog kao što je Mediteran.Jedno od temeljnih posredovanja, iz kojeg (...) proizlaze ostala, jest odnos čovjeka i čovjeka, što bi se, govoreći jezikom pitanja, moglo drukčije odrediti kao pitanje mogućnosti i svrhe ljudske zajednice, odnosno bîti političkog. Na Mediteranu je, između ostalog, izvorište dva, mogli bismo reći oprečna, ali određujuća pristupa ovom pitanju: tzv. tradicionalni pristup politici – antičkogrčko shvaćanje politike kao djelovanja slobodnih i jednakih građana, koji u državi kao političkoj zajednici ozbiljuju bitne svrhe ljudskoga dobroga i pravednog života te čiji najreljefniji izraz nalazimo kod Aristotela , dok je s druge strane ono što nazivamo novovjekovnim pristupom politici, koji predstavlja nasuprotni pol antičkogrčkom određenju odnosa. Radikalni obrat nastupa upravo s Machiavellijem, a raščlambom njegova djela razabiru se i utjecaji na suvremenost.The Mediterranean is a meeting point. On the one hand, meeting points imply communication, activity, openness and interlacement, while on the other, conflict, frequently even war, destruction and extermination. Meetings, therefore, represent both danger and opportunity, threat and occasion, the possibility of annihilation and a model of a new quality, which the Mediterranean clearly mirrors. Its endless tension, the relations between harmony and opposition, its similarities and differences reveal the Mediterranean, in its essence, as a zone of mediation, and mediation itself as the very prerequisite of the existence of something like the Mediterranean.One of the most fundamental mediations, out of which all the others derive, is the relationship between man and man. Once translated into the language of questions, this could be reformulated as the question of the possibility and purpose of human society, i.e. the essence of the political. The Mediterranean is, amongst other things, the source of two, one could say diametrically opposed yet determinative approaches to this issue: one is the so-called traditional approach to politics – the Ancient Greek understanding of politics as a set of actions by free and equal citizens, who fulfil the purposes of a good and virtuous life in a state as a political community, the most outstanding example of which is formulated by Aristotle – while the other is the so-called modern approach to politics, which is the polar opposite of the Ancient Greek definition of the relationship at hand. With Machiavelli a radical shift takes place, and the analyses of his work disclose his influence on contemporaneity. (shrink)

Hyperbaric oxygen (HBO) therapy still lacks proper interpretations of its many actions. This hypothesis is based on reports of temporarily elevated peripheral vascular resistance (PVR) during HBO sessions. Besides that, during HBO sessions, hyperoxygenated tissues can reduce their perfusion so much that CO2 can accumulate in them. Tissue perfusion depends on vascular innervation and on the balance between systemic constrictors and local dilators. During an HBO session, increased tissue oxygen levels suppress dilatory mechanisms. Tissue hyperoxygenation increases PVR, suggesting that the (...) HBO action on an edematous tissue may be caused by an oxygen‐induced disbalance among Starling capillary forces. The presented hypothesis is that oxygen‐caused arteriolar constriction reduces the hydrostatic pressure in downstream capillaries. Thus, more tissue fluid is absorbed in vascular capillaries, under the condition that the plasma colloid osmotic pressure remains unaltered during the HBO session. Among several known mechanisms behind the HBO actions, the vasoconstriction has been listed as a therapeutic modality for the reduction of the tissue edema, for a crush injury, for burns (in an acute phase), and for the compartment syndrome. The Bell's palsy is among often listed indications for the HBO treatment, although evidence is poor and reports of randomized trials are scarce. (shrink)

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians (n = 22), nurses (n = 15), social workers (n = 7), and allied health providers (n = 4). The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at (1) the individual level: (a) a new end-of-life option, (b) patients’ last chance to express control over their lives, (c) patient and family comfort and relief, and (d) a unique learning experience for hospice palliative care providers; (2) the team level: (a) supportive collegial relationships, (b) broadened discussions about end-of-life and palliative care, and (c) team debriefs provide opportunities for education and support; and (3) the institutional level: (a) improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

Organizations are increasingly looking for ways to reap the benefits of cognitive diversity for problem solving. A major unanswered question concerns the implications of cognitive diversity for longer-term outcomes such as team learning, with its broader effects on organizational learning and productivity. We study how cognitive style diversity in teams—or diversity in the way that team members encode, organize and process information—indirectly influences team learning through collective intelligence, or the general ability of a team to work together across a wide (...) array of tasks. Synthesizing several perspectives, we predict and find that cognitive style diversity has a curvilinear—inverted U-shaped—relationship with collective intelligence. Collective intelligence is further positively related to the rate at which teams learn, and is a mechanism guiding the indirect relationship between cognitive style diversity and team learning. We test the predictions in 98 teams using ten rounds of the minimum-effort tacit coordination game. Overall, this research advances our understanding of the implications of cognitive diversity for organizations and why some teams demonstrate high levels of team learning in dynamic situations while others do not. (shrink)

Artificial intelligence (AI) technologies in medicine are gradually changing biomedical research and patient care. High expectations and promises from novel AI applications aiming to positively impact society raise new ethical considerations for patients and caregivers who use these technologies. Based on a qualitative content analysis of semi-structured interviews and focus groups with healthcare professionals (HCPs), patients, and family members of patients with Parkinson’s Disease (PD), the present study investigates participant views on the comparative benefits and problems of using human versus (...) AI predictive computer vision health monitoring, as well as participants’ ethical concerns regarding these technologies. Participants presumed that AI monitoring would enhance information sharing and treatment, but voiced concerns about data ownership, data protection, commercialization of patient data, and privacy at home. They highlighted that privacy issues at home and data security issues are often linked and should be investigated together. Findings may help technologists, HCPs, and policymakers determine how to incorporate stakeholders’ intersecting but divergent concerns into developing and implementing AI PD monitoring tools. (shrink)

Recent findings indicate that frontal brain asymmetry may be a marker of for depression. However, the psychological predispositions that account linkage between frontal brain asymmetry and depression are unclear. approach-withdrawal hypothesis is the primary framework that has been to account for the linkages between frontal brain asymmetry and or emotional disorders. We review evidence consistent with this and suggest several directions for its extension. One such direction is to constrain the approach-withdrawal hypothesis by linking frontal asymmetry to the known functions (...) of the prefrontal cortex. On this we propose that frontal brain asymmetry may be preferentially linked processes that promote the temporal continuity and shifting of or emotional priorities and the suppression of interference by sources of motivation or emotion. We review evidence from and neurobiological studies of depression that is broadly consistent with these predictions. We emphasise the need for future studies testing our hypotheses. (shrink)

The aim of this analysis was to examine the concept of time to rejuvenate and extend existing narratives of time within the nursing literature. In particular, we hope to promote a new trajectory in nursing research and practice which focuses on time and person‐centred care, specifically of older people with cognitive impairment hospitalized in the acute care setting. We consider the explanatory power of concepts such as clock time, process time, fast care, slow care and time debt for elucidating the (...) relationship between ‘good care’ and ‘time use’. We conclude by offering two additional concepts of time, plurotemporality and person‐centred time (PCT) which we propose will help advance of nursing knowledge and practice. Nurse clinicians and researchers can use these alternative concepts of time to explore and describe different temporal structures that honour the patient's values and preferences using experiential, observation‐based nursing research approaches. (shrink)

The research paper elaborates on the main concepts and terminology of strategic planning in education, including all the steps of building a strategic plan with mission and vision statements. Furthermore, it analyses and compares some successful strategic planning case studies in education by identifying the strengths and some weaknesses. The final results of this inquiry serve as recommendations for positive changes and reforms in North Macedonian education. Furthermore, this research paper emphasizes the importance of the SMART strategic goals for improving (...) education, articulated via the mission and vision statements. It is quite interesting that internationally accredited educational organizations like NOVA IS of Skopje have more successful improvement plans based on shared values and goals via their mission and vision. The implementation of their strategic plans is closely monitored and evaluated. Moreover, some successful educational reforms happened in Finland, Singapore, and Victoria, Australia, and their ministries of education are dedicated and accountable to aligning their mission and vision with all public schools in these countries. On the contrary, although the Ministry of Education of North Macedonia has clearly published the mission and vision statements, there is still a huge gap in the reality of implementation of those in all public schools, and rarely any school has a shared mission and vision on their web page. Browsing around, one primary school in North Macedonia, “Jan Amos Komenski” has recently started sharing their school’s mission and vision, values, and goals with the community which is a positive change toward SMART reforms. Strategic planning affects the improvement of learning and teaching; therefore it needs to be built inclusively and wisely. (shrink)

The contributions gathered in this volume present the state of the art in key areas of current social ontology. They focus on the role of collective intentional states in creating social facts, and on the nature of intentional properties of groups that allow characterizing them as responsible agents, or perhaps even as persons. Many of the essays are inspired by contemporary action theory, emotion theory, and theories of collective intentionality. Another group of essays revisits early phenomenological approaches to social ontology (...) and accounts of sociality that draw on the Hegelian idea of recognition. This volume is organized into three parts. First, the volume discusses themes highlighted in John Searle's work and addresses questions concerning the relation between intentions and the deontic powers of institutions, the role of disagreement, and the nature of collective intentionality. Next, the book focuses on joint and collective emotions and mutual recognition, and then goes on to explore the scope and limits of group agency, or group personhood, especially the capacity for responsible agency. The variety of philosophical traditions mirrored in this collection provides readers with a rich and multifaceted survey of present research in social ontology. It will help readers deepen their understanding of three interrelated and core topics in social ontology: the constitution and structure of institutions, the role of shared evaluative attitudes, and the nature and role of group agents. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

Management of effort is one of the biggest challenges in any team, and is particularly difficult in distributed teams, where behavior is relatively invisible to teammates. Awareness systems, which provide real-time visual feedback about team members’ behavior, may serve as an effective intervention tool for mitigating various sources of process-loss in teams, including team effort. However, most of the research on visualization tools has been focusing on team communication and learning, and their impact on team effort and consequently team performance (...) has been hardly studied. Furthermore, this line of research has rarely addressed the way visualization tool may interact with team composition, while comprehension of this interaction may facilitate a conceptualization of more effective interventions. In this article we review the research on feedback in distributed teams and integrate it with the research on awareness systems. Focusing on team effort, we examine the effect of an effort visualization tool on team performance in 72 geographically distributed virtual project teams. In addition, we test the moderating effect of team composition, specifically team members’ conscientiousness, on the effectiveness of the effort visualization tool. Our findings demonstrate that the effort visualization tool increases team effort and improves the performance in teams with a low proportion of highly conscientious members, but not in teams with a high proportion of highly conscientious members. We discuss the theoretical and practical implications of our findings, and suggest the need of future research to address the way technological advances may contribute to management and research of team processes. (shrink)

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...) pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

Result of a conference, "Sociobiology: implications for human studies", held at San Francisco State University on June 14-15, 1977. Includes index. Bibliography: p. 295-316.

Federal and state budgetary constraints continually challenge Medicaid. The effects of benefit cuts are common: long waiting lists for community‐based services, skeletonized drug formularies with unstable access to long‐term prescriptions, no psychiatric therapy for people immobilized by depression, and no more than fourteen days of acute hospitalization. Reimbursements may be so low that providers cannot hire qualified staff and must reduce services, close facilities, or refuse to take Medicaid altogether. Misguided efficiency policies may afflict some groups of patients as well. (...) Decisions to narrow access rights to publicly funded health care promote the perception that more broadly inclusive programs would be unwisely and unfairly generous. They also risk characterizing disability rights as “special,” confined to a narrow class of people who charitably ought not to be expected to provide for themselves. In contrast, on a philosophical view we have been exploring—one that addresses problems of justice under circumstances of injustice by pursuing rather than reducing inclusion—efforts like these are unjust. (shrink)

Volume 24, Issue 8, August 2024, Page 90-93.

Depression is a widespread concern in the United States. Neuromodulation treatments are becoming more common but there is emerging concern for racial disparities in neuromodulation treatment utilization. This study focuses on Transcranial Magnetic Stimulation (TMS), a treatment for depression, and the structural and attitudinal barriers that racialized individuals face in accessing it. In January 2023 participants from the Twin Cities, Minnesota engaged in focus groups, coupled with an educational video intervention. Individuals self identified as non-white who had no previous TMS (...) exposure but had tried at least one treatment for their depression. Results revealed that the intervention did not notably change knowledge or stigma about TMS, but attitudes surrounding traveling for treatment changed. Notably, barriers like affordability, frequency of treatment, and lack of knowledge persist. Participants expressed a desire for more information, personal connection, and a tailored educational approach. The study suggests a need for multifaceted strategies to reduce disparities, focusing on education, community-based resources, and policy interventions. Immediate actions that can be taken include the creation of a TMS education program focused on patient engagement and awareness about TMS. (shrink)

Resumen: Este estudio examina la frecuencia de colocaciones gramaticales verbo + preposición en aprendientes anglófonos de Español como Lengua Extranjera de nivel A2 y B1 bajo el modelo de Análisis Contrastivo de la Interlengua. Para ello se implementa una tipología colocacional sustentada en un criterio de fijación intermedia de estas unidades. Los resultados muestran mayor frecuencia en el nivel B1, pero no en la variedad de unidades, y un mayor número de usos correctos que en A2. Respecto de las diferencias (...) encontradas según el patrón sintáctico-semántico, las variables competencia, complejidad del patrón y temáticas aparecen como factores importantes para explicarlas en el contexto del corpus de aprendientes examinado. Este trabajo aporta al estudio de las ColGram v+p, y de otros tipos en ELE.: This study examines the frequency of grammatical collocations verb + preposition in L1-English learners of Spanish as a Foreign Language of levels A2 and B1 under the model of Interlanguage Contrastive Analysis. To this end, a collocational typology based on a criterion of intermediate fixedness was implemented. The results show higher frequency in level B1, but not in the variety of the units, and a greater number of correct uses than in A2. Regarding found differences according to syntactic and semantic pattern, the variables of competence, pattern complexity and theme appear to play an important role in their explanation in the context of the learners’ corpus examined. This work contributes to the study of GramCol v+p and other types in SFL. (shrink)

We draw insights from Activity Theory within the field of human-computer interaction to quantitatively measure a mobile in-store experience (MIX), which includes the suite of shopping activities and retail services that a consumer can engage in when using their mobile device in brick-and-mortar stores. We developed and validated a nine-item, formative MIX index using survey data collected from fashion consumers in the United States (n= 1,267), United Kingdom (n= 370), Germany (n= 362), and France (n= 219). As survey measures of (...) consumer engagement in omnichannel retailing using a mobile device, the index items with stronger factor loadings described in-store shopping activities whereas those with weaker factor loadings described activities related to behavioral targeting and social networking. These results suggest that retailers should give consumers the autonomy to independently find, evaluate and purchase merchandise in brick-and-mortar stores, thereby enabling them to co-create personalized shopping experiences as active participants within an omnichannel retail servicescape. Our findings also suggest that retailers should provide consumers with more authentic ways to build community and brand affiliations than mobile marketing and social media promotions. In-store activities should not simply be a migration of pre-existing e-commerce capabilities onto mobile devices. An engaging mobile in-store experience should be an amalgam of physical and digital activities that produce a seamless shopping journey and leverage the unique properties of mobile devices – ultra-portability, location sensitivity, untetheredness, and personalization. Retail executives can use the validated MIX index to prepare strategic investments in mobile technology applications and capabilities for retail stores within their omnichannel operations. The nine-item MIX index is also well-suited for consumer surveys, which also makes it an attractive measure of consumer engagement in omnichannel retailing for future academic research. (shrink)

Mobile technologies such as tablets, iPads, laptops, netbooks as well as mobile phones with internet connectivity and recording features present new challenges to the academy. In the age of convergence and with the encoding of several features into mobile telephony, private spaces of the classroom can be reconfigured through the mediation of technologies. In most cases, existing rules and regulations of higher education institutions do not comprehensively address these challenges. The introduction of new technologies into the classroom has been often (...) framed historically as vital and relevant for a progressive academic society or as part of a national imperative to transform the ways in which the authors access and engage with knowledge. This paper surveys British universities to examine how they govern the phenomenon of recording content through mobile technologies. The results reveal a pervasive use of mobile devices in UK universities and clear divergences in approaches to enacting mobile device-specific policies to govern the usage of these technologies. (shrink)

Prevailing philosophies about parental and other caregiver responsibilities toward children tend to be protectionist, grounded in informed benevolence in a way that countenances rather than circumvents intrusive paternalism. And among the kinds of children an adult might be called upon to parent or otherwise care for, children with disabilities figure among those for whom the strongest and snuggest shielding is supposed be deployed. In this article, we examine whether this equation of securing well-being with sheltering by protective parents and other (...) care-givers should unreflectively be adopted for disabled children. We also consider why healthcare providers might reasonably be reluctant to yield to this principle, even if parents instinctively suppose that protectionism is the parenting policy that best serves their disabled child’s interest. We contend that caregivers owe children with disabilities at least as much, and possibly more, respect for self-governance than other children need. In spite of disabled children’s vulnerability and even in view of it, we argue that they should be accorded not only welfare rights to well-being but at least a modified version of liberty rights as well. Healthcare providers are especially favorably positioned to facilitate the latter response. The main components of respectful caregiving can come into conflict with one another, but we present some priorities that advise against adopting a protectionist account of parenting rights, or at least against accepting protectionist views that focus parenting narrowly on shaping ideas about the child’s welfare. In sum, caring for a disabled child, we argue, involves more than creating conditions that will afford her contentment and comfort over the course of life. (shrink)

A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

Communities, scientists, policy-makers and industries are requiring farmers to address environmental and wellbeing challenges in their on-farm management, transitioning away from a productivity dominated focus towards a multi-faceted system focus that includes environmental and social values. This paper analyses how Miraka Ltd., an Aotearoa-New Zealand indigenous owned and operated milk company, has taken on the role of institutional entrepreneur to enable and support change towards a multi-faceted system amongst its supply farmers. Observations and interviews were carried out to: (i) identify (...) farmers’ changes in practices, beliefs and values over the last ten years; and (ii) identify how Miraka functions as an indigenous entrepreneur in the agricultural sector. Findings show that interviewees were initially guided by business and family-oriented values, beliefs and practices, but in response to the institutional entrepreneurship by Miraka, approximately half of the interviewees changed these values, beliefs and practices, by internalising people and environmental values. The main strategies employed by Miraka were mobilisation of material resources such as incentives and awards, creation of a rationale addressing environmental and social concerns in the dairy sector, and proactive connection with new actors. The research shows an indigenous owned small-medium enterprise can make changes in values, beliefs and practices amongst its supply farmers, but requires a stronger shared base of values to contribute to a wider economic change. The discussion connects these findings to wider literature on diverse economies and indigenous entrepreneurship to identify to what extent an indigenous small-medium enterprise can contribute to a system change. (shrink)

Die Studie untersucht die systematischen Beziehungen der zentralen Begriffe in Bernard Bolzanos Erkenntnistheorie, die einen logisch-semantischen Realismus mit einer kausalistischen Metaphysik des Geistes verknüpft. Bolzano situiert grundlegende epistemische Aktivitäten wie Vorstellen, Urteilen und Ableiten im Spannungsfeld von logischen Relationen und dem Kausalnexus mentaler Episoden. Die Studie erläutert die Bedeutung der prominenten Begriffe 'Kraft' und 'Wahrscheinlichkeit' im Hinblick auf die erkenntnistheoretischen Belange von Wissen und Rechtfertigung. Der Begriff der Kraft begründet eine kausalistische Metaphysik von Geist und Welt und damit die Bedingungen (...) faktischer Erkenntnisverläufe. Der Begriff der Wahrscheinlichkeit bezeichnet Begründungsrelationen zwischen objektiven Propositionen, die für die rationale Berechtigung von Überzeugungen bestimmend sind. Zusammen konstituieren Faktivität und Normativität von Erkenntnisansprüchen die epistemische Wahrscheinlichkeit der "Zuversicht", die Urteilen einerseits assertive Kraft und andererseits die Berechtigung verleiht, sie als Erkenntnis anzunehmen. (shrink)

Reindeer meat, traditional food and knowledge are vital for the culture, health, and economy of Sámi reindeer herders. Nevertheless, the practices of reindeer meat smoking have barely been part of scientific research or reindeer herding management. We investigated Sámi reindeer herders’ approach to meat smoking in Northern Norway performed in the traditional Sámi tent, the lávvu. The investigation included workshops, interviews, participatory observations, and co-analyze meetings. Our findings reveal a typology of the traditional Sámi smoking practices. Sámi reindeer herders use (...) a variety of wood species and plant parts to control the smoke based on a complex system of traditional knowledge. Yet there is a need for education, industry, and research acknowledging, supporting, and maintaining the Sámi meat-smoking process and associated worldviews, knowledge, and practices to ensure ethical, sustainable, and healthy food production. (shrink)

When physicians take readings of health indices such as temperature or blood pressure, the practices that physicians and patients employ in discussing the readings both reflect and propose a set of expectations regarding the level of technical medical information the patients should acquire and understand. In this article we demonstrate how physicians’ reporting practices reflect and propose the roles of paternalism or independent expertise and how patients’ responding practices either ratify or contest the roles cast by the physicians’ practices. In (...) contrast to the usual assumption that roles are relatively stable for individuals over the course of encounters, we treat role enactments as matters that are negotiated turn by turn in interaction. Physicians’ practices for reporting test results implicate various sets of expectations about the knowledge, interest, and responsibility state of each participant; patients employ responding practices that ratify or contest the expectations implicated by the physicians’ prior report. In each subsequent turn within the information exchange sequence, a speaker indicates whether the level and kind of information being exchanged is appropriate/inappropriate and sufficient/insufficient for the participants. (shrink)

The proliferation of big data analytics in criminal justice suggests that there are positive frames and imaginaries legitimising them and depicting them as the panacea for efficient crime control. Criminological and criminal justice scholarship has paid insufficient attention to these frames and their accompanying narratives. To address the gap created by the lack of theoretical and empirical insight in this area, this article draws on a study that systematically reviewed and compared multidisciplinary academic abstracts on the data-driven tools now shaping (...) decision-making across several justice systems. Using insights distilled from the study, the article proposes three frames for understanding how the technologies are portrayed. Inherent in the frames are a set of narratives emphasising their ostensible status as vital crime control mechanisms. These narratives obfuscate the harms of data-driven technologies and evince idealistic imaginaries of their capabilities. The narratives are bolstered by unequal structural arrangements, specifically the unevenly distributed digital capital with which some are empowered to participate in technology development for criminal justice application and other forms of penal governance. In unravelling these issues, the article advances current understanding of the dynamics that sustain the depiction of data-driven technologies as prime crime prevention and law enforcement tools. (shrink)